Development of tissue culture procedures for predicting the individual risk of recurrence in bladder cancer.

We are using three correlated approaches in tissue culture to develop procedures for distinguishing between histologically similar tumors and to develop distinctions that we hope can be correlated with a favorable outcome or with recurrence of more serious disease. Our procedures involve study of the growth of resected tumor tissue in a three-dimensional matrix of collagen-coated cellulose sponge. Using bladder cancer cell lines we are also studying the patterns of cytotypic zonation that appear in response to prolonged exposure to continuous gradients of oxygen tension and of temperature. Finally, we are using vitamin A and modifiers of cyclic adenosine 3':5'-monophosphate as molecular probes to alter the morphological expression of tumors in matrix and in gradient cultures. We have studied over 80 specimens of clinical cancer in matrix culture. Tumors of similar histopathology grow with distinctly different architecture in the matrix of collagen-coated sponge. We must now determine whether these patterns in vitro can be correlated with the course of individual patients.